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General NPI Number Information
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NPI Number | 1780204420
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Entity Type | Organization
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Legal Business Name | OCCUPATIONAL ADVANTAGE
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Dates
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Enumeration Date | 04/23/2020
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Last Update Date | 02/18/2025
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Provider Practice Location Address
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Address Line | 2035 N MASON RD STE 502
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City | KATY
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State | TX
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Zip | 77449-6879
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Country | US
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Telephone | 832-680-3561
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Fax |
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Provider Business Mailing Address
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Address Line | 2035 N MASON RD STE 502
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City | KATY
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State | TX
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Zip | 77449-6879
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Country | US
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Telephone | 832-680-3561
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Fax |
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Authorized Official
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Title or Position | OWNER/MEMBER
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Name | DIONISE HEREDIA-THOMAS
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Credential | OTR
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Telephone | 361-537-8463
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 235Z00000X
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Taxonomy Name | Speech-Language Pathologist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number |
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License Number State |
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